BILL NUMBER: AB 1215	CHAPTERED  09/28/99

	CHAPTER   549
	FILED WITH SECRETARY OF STATE   SEPTEMBER 28, 1999
	APPROVED BY GOVERNOR   SEPTEMBER 28, 1999
	PASSED THE ASSEMBLY   AUGUST 26, 1999
	PASSED THE SENATE   AUGUST 23, 1999
	AMENDED IN SENATE   JUNE 17, 1999
	AMENDED IN ASSEMBLY   APRIL 5, 1999

INTRODUCED BY   Assembly Member Thomson

                        FEBRUARY 26, 1999

   An act to amend Sections 1797.172 and 1798.200 of the Health and
Safety Code, relating to emergency medical services, and declaring
the urgency thereof, to take effect immediately.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1215, Thomson.  Emergency medical services.
   Existing law, the Emergency Medical Services System and the
Prehospital Emergency Medical Care Personnel Act, requires the state
Emergency Medical Services Authority to adopt, after approval of the
commission, minimum standards for the training and scope of practice
of an emergency medical technician-paramedic (EMT-P).  Existing law
requires that each application for licensure or licensure renewal of
an EMT-P include the applicant's social security number to establish
the applicant's identity and criminal convictions, if any.
   This bill would require each application for licensure or
licensure renewal to include one fingerprint card from all applicants
and an additional fingerprint card from applicants who have not
continuously resided in the state for the previous 7 years or when
the authority has credible evidence that the applicant has a criminal
history outside of California.  The bill would require these latter
fingerprints to be submitted to the Department of Justice to be
forwarded to the Federal Bureau of Investigation.  The bill would
authorize the authority to charge a fee for services related to these
fingerprinting and criminal record checks.
   Under the Emergency Medical Services System and the Prehospital
Emergency Medical Care Personnel Act, each county may designate an
emergency medical services agency (local EMS agency) for the
establishment and administration of an emergency medical services
program in the county, administered by the medical director.
Existing law sets forth several grounds under which the medical
director, in accordance with regulations adopted by the authority,
may deny, suspend, or revoke a certificate, or for which the medical
director may place a certificate holder on probation.
   This bill would revise this provision to authorize the medical
director to deny, suspend, or revoke a certificate, or place a
certificate holder on probation, in accordance with specified
regulations.
   The Administrative Procedure Act contains provisions governing the
conduct of administrative adjudication and rulemaking proceedings of
state agencies.
   This bill would require the authority to ensure that the local EMS
agency's disciplinary policies and procedures are at least as
effective in protecting the due process rights of any EMT-I or EMT-II
certificate holder as those in the Administrative Procedure Act and
would require that proceedings of the authority against any EMT-P
license or licenseholder be in accordance with the Administrative
Procedure Act.  Because this bill would increase the duties of the
local EMS authority with regard to disciplinary policies and
procedures, this bill would impose a state-mandated local program.
   Existing law sets forth certain actions that subject an EMT-P to
administrative sanctions.
   This bill would add unprofessional conduct as provided under the
bill to the list of actions that would subject an EMT-P to
administrative sanctions.
  The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state.  Statutory provisions establish procedures for making that
reimbursement, including the creation of a State Mandates Claims Fund
to pay the costs of mandates that do not exceed $1,000,000 statewide
and other procedures for claims whose statewide costs exceed
$1,000,000.
   This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
   This bill would declare that it is to take effect immediately as
an urgency statute.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  The Legislature finds and declares as follows:
   (a) Paramedics with out-of-state criminal records have been
unknowingly licensed by the California Emergency Medical Services
Authority because the authority does not access federal criminal
background information.
   (b) Paramedics continue to move here from out of state because the
wages and weather conditions in California make it a desirable place
to work.
   (c) Cases of physical and sexual abuse by paramedics have been
proven and admitted.
  SEC. 2.  Section 1797.172 of the Health and Safety Code is amended
to read:
   1797.172.  (a) The authority shall develop, and after the approval
of the commission pursuant to Section 1799.50, shall adopt, minimum
standards for the training and scope of practice for EMT-P.
   (b) The approval of the director, in consultation with a committee
of local EMS medical directors named by the EMS Medical Directors
Association of California, is required prior to implementation of any
addition to a local optional scope of practice for EMT-Ps proposed
by the medical director of a local EMS agency.
   (c) Notwithstanding any other provision of law, the authority
shall be the agency solely responsible for licensure and licensure
renewal of EMT-Ps who meet the standards and are not precluded from
licensure because of any of the reasons listed in subdivision (d) of
Section 1798.200.  Each application for licensure or licensure
renewal shall require the applicant's social security number in order
to establish the identity of the applicant and a fingerprint card in
order to determine whether the applicant has any criminal
convictions in this state or any other jurisdiction, including
foreign countries.  The authority shall obtain a second fingerprint
card for submission to the Department of Justice to be forwarded to
the Federal Bureau of Investigation for processing from those
applicants for licensure or licensure renewal who have not
continuously resided in the state for the previous seven years, or
when the authority has been presented with credible evidence that the
applicant has a criminal history outside of California.  The
information obtained as a result of obtaining the applicant's social
security number and fingerprint card or cards shall be used in
accordance with Section 11105 of the Penal Code, and to determine
whether the applicant is subject to denial of licensure or licensure
renewal pursuant to this division.  A fingerprint card may not be
required for licensure renewal upon determination by the authority
that a fingerprint card was already obtained during initial
licensure, or a previous licensure renewal, provided that the license
has not lapsed and the applicant has resided continuously in the
state since the initial licensure.
   (d) The authority shall charge fees for the licensure and
licensure renewal of EMT-Ps in an amount sufficient to support the
authority's licensure program at a level that ensures the
qualifications of the individuals licensed to provide quality care.
The basic fee for licensure or licensure renewal of an EMT-P shall
not exceed one hundred twenty-five dollars ($125).  Separate
additional fees may be charged, at the option of the authority, for
services that are not shared by all applicants for licensure and
licensure renewal, including, but not limited to, any of the
following services:
   (1) Initial application for licensure as an EMT-P.
   (2) Competency testing, the fee for which shall not exceed thirty
dollars ($30), except that an additional fee may be charged for the
cost of any services that provide enhanced availability of the exam
for the convenience of the EMT-P, such as on-demand electronic
testing.
   (3) Fingerprint and criminal record check.  The applicant shall,
if applicable according to subdivision (c), submit two fingerprint
cards for criminal record checks with the Department of Justice and
the Federal Bureau of Investigation.
   (4) Out-of-state training equivalency determination.
   (5) Verification of continuing education for a lapse in licensure.

   (6) Replacement of a lost licensure card.  The fees charged for
individual services shall be set so that the total fees charged to
EMT-Ps shall not exceed the authority's actual total cost for the
EMT-P licensure program.
   (e) The authority may provide nonconfidential, nonpersonal
information relating to EMS programs to interested persons upon
request, and may establish and assess fees for the provision of this
information.  These fees shall not exceed the costs of providing the
information.
   (f) At the option of the authority, fees may be collected for the
authority by an entity that contracts with the authority to provide
any of the services associated with the EMT-P program.  All fees
collected for the authority in a calendar month by any entity
designated by the authority pursuant to this section to collect fees
for the authority shall be transmitted to the authority for deposit
into the Emergency Medical Services Personnel Fund within 30 calendar
days following the last day of the calendar month in which the fees
were received by the designated entity, unless the contract between
the entity and the authority specifies a different timeframe.
  SEC. 3.  Section 1798.200 of the Health and Safety Code is amended
to read:
   1798.200.  (a) The medical director of the local EMS agency may,
in accordance with Chapter 6 (commencing with Section 100206) of
Division 9 of Title 22 of the California Code of Regulations, deny,
suspend, or revoke any EMT-I or EMT-II certificate issued under this
division, or may place any EMT-I or EMT-II certificate holder on
probation, upon the finding by that medical director of the
occurrence of any of the actions listed in subdivision (c).  The
authority shall ensure that the local EMS agency's disciplinary
policies and procedures are, at a minimum, as effective in protecting
the due process rights of any EMT-I or EMT-II certificate holder as
those in Chapter 5 (commencing with Section 11500) of Part 1 of
Division 3 of Title 2 of the Government Code.
   (b) The authority may deny, suspend, or revoke any EMT-P license
issued under this division, or may place any EMT-P license issued
under this division, or may place any EMT-P licenseholder on
probation upon the finding by the director of the occurrence of any
of the actions listed in subdivision (c).  Proceedings against any
EMT-P license or licenseholder shall be held in accordance with
Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of
Title 2 of the Government Code.
   (c) Any of the following actions shall be considered evidence of a
threat to the public health and safety and may result in the denial,
suspension, or revocation of a certificate or license issued under
this division, or in the placement on probation of a certificate or
licenseholder under this division:
   (1) Fraud in the procurement of any certificate or license under
this division.
   (2) Gross negligence.
   (3) Repeated negligent acts.
   (4) Incompetence.
   (5) The commission of any fraudulent, dishonest, or corrupt act
which is substantially related to the qualifications, functions, and
duties of prehospital personnel.
   (6) Conviction of any crime which is substantially related to the
qualifications, functions, and duties of prehospital personnel.  The
record of conviction or a certified copy of the record shall be
conclusive evidence of the conviction.
   (7) Violating or attempting to violate directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
any provision of this division or the regulations adopted by the
authority pertaining to prehospital personnel.
   (8) Violating or attempting to violate any federal or state
statute or regulation which regulates narcotics, dangerous drugs, or
controlled substances.
   (9) Addiction to the excessive use of, or the misuse of, alcoholic
beverages, narcotics, dangerous drugs, or controlled substances.
   (10) Functioning outside the supervision of medical control in the
field care system operating at the local level, except as authorized
by any other license or certification.
   (11) Demonstration of irrational behavior or occurrence of a
physical disability to the extent that a reasonable and prudent
person would have reasonable cause to believe that the ability to
perform the duties normally expected may be impaired.
   (12) Unprofessional conduct exhibited by any of the following:
   (A) The mistreatment or physical abuse of any patient resulting
from force in excess of what a reasonable and prudent person trained
and acting in a similar capacity while engaged in the performance of
his or her duties would use if confronted with a similar
circumstance.  Nothing in this section shall be deemed to prohibit an
EMT-I, EMT-II, or EMT-P from assisting a peace officer, or a peace
officer who is acting in the dual capacity of peace officer and
EMT-I, EMT-II, or EMT-P, from using that force that is reasonably
necessary to effect a lawful arrest or detention.
   (B) The failure to maintain confidentiality of patient medical
information, except as disclosure is otherwise permitted or required
by law in Sections 56 to 56.6, inclusive, of the Civil Code.
   (C) The commission of any sexually related offense specified under
Section 290 of the Penal Code.
  SEC. 4.  Notwithstanding Section 17610 of the Government Code, if
the Commission on State Mandates determines that this act contains
costs mandated by the state, reimbursement to local agencies and
school districts for those costs shall be made pursuant to Part 7
(commencing with Section 17500) of Division 4 of Title 2 of the
Government Code.  If the statewide cost of the claim for
reimbursement does not exceed one million dollars ($1,000,000),
reimbursement shall be made from the State Mandates Claims Fund.
  SEC. 5.  This act is an urgency statute necessary for the immediate
preservation of the public peace, health, or safety within the
meaning of Article IV of the Constitution and shall go into immediate
effect.  The facts constituting the necessity are:
   In order to authorize the California Emergency Medical Services
Authority to implement a federal background check process as soon as
possible to ensure the timely investigation of certain persons
applying for licensure as a paramedic who have resided out of state
or may have a criminal history outside of California.
